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<title>Virtual Heart Museum</title>
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	<h1>Add New Specimen</h1>
	 	<p> 
         Instructions for adding a new specimen to the museum:
         	
          <p>
          We thank you for your contribution! </p>
          <form name="add_new_specimen" action="<?php echo site_url('index.php/welcome/submit_specimen');?>" method="post">
		            <table cellspacing="10">
		           <tr> <td>

		             <p>Abdominal Position: </p></td> 
		           <td>  <select name="Pos_Abd">
						  <option value="Usual">Usual</option>
						  <option value="Mirror Image">Mirror Image</option>
						  <option value="Ambiguous">Ambiguous</option>
						  <option value="Indeterminate">Indeterminate</option>
						</select> 
					</td>
		           
		           <td>
		              <p>Heart Position: </p></td> 
		            <td>  
		             <select name="Pos_Cor">
						  <option value="Right">Right</option>
						  <option value="Left">Left</option>
						  <option value="Midline">Midline</option>
						  <option value="Ectopic">Ectopic</option>
						</select> 
		            </td>
		           
		           <td>
		              <p>Aorta: </p></td> 
		            <td>  
		             <select name="AO_Art">
						  <option value="Normal">Normal</option>
						  <option value="Atretic">Atretic</option>
						  <option value="Hypoplastic">Hypoplastic</option>
						  <option value="Absent">Absent</option>
						  <option value="Other">Other</option>
						  <option value="Left Arch">Left Arch</option>
						  <option value="Right Arch">Right Arch</option>
						  <option value="Coarctation">Coarctation</option>
						  <option value="Interruption">Interruption</option>
						</select> 
		            </td>
		           </tr> 
		           <tr> <td>
		             <p>Apex Position: </p></td> 
		           <td>  <select name="Apex_Cor">
						  <option value="Right">Right</option>
						  <option value="Left">Left</option>
						  <option value="Midline">Midline</option>
						  <option value="Other">Other</option>
						</select> 
					 </td>
		           
		            <td>
		              <p>Systemic Venous Connections: </p></td> 
		            <td>  <select name="Sys_Ven_Conn">
						  <option value="Normal">Normal</option>
						  <option value="Abnormal">Abnormal</option>
						</select>  </td>
		            
		            <td>
		              <p>Coronary Arteries: </p></td> 
		            <td>  <select name="Coronary">
						  <option value="Normal">Normal</option>
						  <option value="Abnormal">Abnormal</option>
						</select>  
					</td>
		           </tr> 
		           <tr> <td>
		             <p>Pulmonary Venous Connections: </p></td> 
		           <td>  <select name="Pul_Ven_Conn">
						  <option value="Normal">Normal</option>
						  <option value="Abnormal">Abnormal</option>
						</select>  </td>
		           
		           <td>
		              <p>Atrial Arrangement: </p></td> 
		            <td>  <select name="Atr_Septum">
						  <option value="Usual">Usual</option>
						  <option value="Mirror Image">Mirror Image</option>
						  <option value="Right Atrial Isomerism">Right Atrial Isomerism</option>
						  <option value="Left Atrial Isomerism">Left Atrial Isomerism</option>
						</select> 
				 </td>
		           <td>
		             <p>Arterial Duct: </p></td> 
		           <td>  <select name="PAD_PDA">
						  <option value="Absent">Absent</option>
						  <option value="Present">Present</option>
						</select>  </td>
		           </tr> 
		            
		            <tr> <td>
		              <p>Atrial Septum: </p></td> 
		            <td>  <select name="Pos_Cor">
						  <option value="Intact">Intact</option>
						  <option value="Oval Fossa Defect">Oval Fossa Defect</option>
						  <option value="Sinus Venosus Defect">Sinus Venosus Defect</option>
						  <option value="Coronary Sinus Defect">Coronary Sinus Defect</option>
						</select> 
					 </td>

					  <td>
		              <p>Pulmonary Branches: </p></td> 
		            <td>  <select name="Pul_Branches">
						  <option value="Normal">Normal</option>
						  <option value="Disconnected">Disconnected</option>
						  <option value="Coarctation">Coarctation</option>
						  <option value="Hypoplastic">Hypoplastic</option>
						  <option value="Absent">Absent</option>
						  <option value="Other">Other</option>
						</select> 
					 </td>
					 
					  <td>
		              <p>Systemic Collaterals: </p></td> 
		            <td>  <select name="MAPCAs">
						  <option value="Absent">Absent</option>
						  <option value="Present">Present</option>
						</select> 
					 </td>					 
		           </tr>   
		           

				<tr> <td>
		              <p>AV Connections: </p></td> 
		            <td>  <select name="AV_Conn">
						  <option value="Concordant">Concordant</option>
						  <option value="Discordant">Discordant</option>
						  <option value="Double Inlet">Double Inlet</option>
						  <option value="Absent Right AV Valve">Absent Right AV Valve</option>
						  <option value="Absent Left AV Valve">Absent Left AV Valve</option>
						  <option value="Double Inlet">Double Inlet</option>
						</select> 
					 </td>
					 
					 <td>
		              <p>AV Junction: </p></td> 
		            <td>  <select name="AV_Junct">
						  <option value="Separate R+L Valves">Separate R+L Valves</option>
						  <option value="Common Valve">Common Valve</option>
						</select> 
					 </td>
					 
					  <td>
		              <p>VA Connections: </p></td> 
		            <td>  <select name="VA_Conn">
						  <option value="Concordant">Concordant</option>
						  <option value="Discordant">Discordant</option>
						  <option value="Double Outlet">Double Outlet</option>
						  <option value="Single Outlet">Single Outlet</option>
						</select> 
					 </td>
		           </tr>   
		           
		           <tr>
		           	<td>
		              <p>Ventricular Septum: </p></td> 
		            <td>  <select name="Vent_Septum">
						  <option value="Intact">Intact</option>
						  <option value="Perimembranous">Perimembranous</option>
						   <option value="Muscular">Muscular</option>
						    <option value="Subarterial">Subarterial</option>
						    <option value="Doubly Committed.">Doubly Committed.</option>
						</select> 
					 </td>
					 
					 <td>
		              <p>Size of Ventricular Defect: </p></td> 
		            <td>  <select name="VSD_Size">
						  <option value="Restrictive">Restrictive</option>
						  <option value="Non-restrictive">Non-restrictive</option>
						</select> 
					 </td>
					 
					  <td>
		              <p>Outflow Tracts: </p></td> 
		            <td>  <select name="Vent_OutFlw_Tracts">
						  <option value="Normal">Normal</option>
						  <option value="Subaortic Stenosis">Subaortic Stenosis</option>
						  <option value="Subpulmonic Stenosis">Subpulmonic Stenosis</option>
						  <option value="Combined Outflow Tract Stenosis">Combined Outflow Tract Stenosis</option>
						</select> 
					 </td>
		           </tr>   
		           
		            <tr>
		           	<td>
		              <p>Pulmonary Valve : </p></td> 
		            <td>  <select name="Pul_Valve">
						  <option value="Normal">Normal</option>
						  <option value="Abnormal">Abnormal</option>
						   <option value="Bicuspid">Bicuspid</option>
						    <option value="Unicuspid">Unicuspid</option>
						    <option value="Multicuspid">Multicuspid</option>
						    <option value="Absent">Absent</option>
						</select> 
					 </td>
					 
					 <td>
		              <p>Pulmonary Trunk: </p></td> 
		            <td>  <select name="Pul_Trunk">
						  <option value="Normal">Normal</option>
						  <option value="Atretic">Non-Atretic</option>
						  <option value="Hypoplastic">Hypoplastic</option>
						  <option value="Absent">Absent</option>
						  <option value="Other">Other</option>
						 </select> 
					 </td>
					 
					  <td>
		              <p>Aortic Valve: </p></td> 
		            <td>  <select name="AO_Valve">
						  <option value="Normal">Normal</option>
						  <option value="Abnormal">Abnormal</option>
						  <option value="Bicuspid">Bicuspid</option>
						  <option value="Unicuspid">Unicuspid</option>
						  <option value="Multicuspid">Multicuspid</option>
						  <option value="Absent">Absent</option>
						</select> 
					 </td>
		           </tr>   
		         </table>
		         
				<input type="submit" value="Add Specimen" /> 
			</form>

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